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The Foot Injuries of Professional Athletes
Section:  Foot Conditions

...I once played three on three basketball against Reggie Jackson at the 92nd Street Y in Manhattan. Boy did he pronate excessively. I would have given him a thumbs down. I guess one never knows. Charles Oakley, former power forward for the NY Knicks, had bunions with chronic dislocation of the second MPJ. The recurrent capsulitis was a real problem. Experts discussing the problem on talk radio worried that Oakley would not be ready come playoff time. One dempsycaller recommended elective amputation of his toe. It sounds crazy, but they were playing Miami in the playoffs and he needed to be ready quickly. In the off season he had surgery to correct the problem.

Tim Bowens had a great career as a nose tackle with the Miami Dolphins. He could stop the run and rush the quarterback with the best of them. Miami stunned the football world when they took him in the first round. He was missing his left hallux and second toe. How did he do his job? I will never know. Tom Dempsey holds the record for the longest field goal in football history. He played his whole career with congenital absence of the right forefoot.

What sports injuries have you been observing or thinking about from your armchair?

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Re: The Foot Injuries of Professional Athletes

As a rather big soccer fan, I find it fascinating to follow the foot and ankle injuries (knocks, as they call them) sustained overseas.  Despite seeing rather large articles dedicated to injuries of very high profile players, I find their attention to detail woefully inadequate.  Take Wayne Rooney, England's David Jeter--if you will, who is currently England's primary striker hope for thier World Cup campaign this summer, who sustained "minor ankle ligament damage."  For an even worse description, Irish Republic international, Stephen Hunt of Hull City FC has sustained a season-ending "foot injury." My fledgling podiatry career put together with fervent following of this sport in un-descriptive newspapers do not agree properly--I would like a bit more description, please.

In the English Premier league injury list currently, 19/74 injuries (26%) are either calf, ankle or foot 'knocks.'  These injuries are described generally:  "calf strain, foot/ankle," or the rather uncharacteristically descriptive "achilles tendinosis." Wow, fair play to ya for that information, but what one of the 26 bones of the foot is ailing Stephen Hunt?!
I suppose it's a metatarsal injury, for these injuries more than any, seem to affect footballers.  Their light, "feel-the-touch-on-the-ball" 'football boots' that can be rolled up and placed in your pocket, leave them prone to metatarsal stress fractures and lisfranc injuries.  I can remember Dr. James Losito in our sports medicine class at Barry University showing us a new shoe produced by a company sponsoring one of the Miami Heat athletes.  He bent the thing in half at the midsole and mused sarcastically about having no idea why these athletes get injured.

Anyway, check out this rather shocking list of top soccer players in the English Premier League with diagnoses,

expected return time and actual return time to match (reference: BBC sport website): 

 Michael Owen (2006): Fifth metatarsal - predicted 6-8 weeks returned 17 weeks later
Wayne Rooney (2004): Fifth metatarsal - predicted 8 weeks returned 14 weeks later
David Beckham (2002): Second metatarsal - predicted 6 weeks returned 7 weeks later
Gary Neville (2002): Fifth metatarsal - predicted 6-8 weeks returned 21 weeks later
Ashley Cole (2005): Fifth metatarsal - predicted 6-8 weeks returned 12 weeks later
Scott Parker (2004): Second metatarsal - predicted 8 weeks returned 34 weeks later
Danny Murphy (2002): Second metatarsal - predicted 6 weeks returned 21 weeks later
Steven Gerrard (2004): Fifth metatarsal - predicted 6-8 weeks returned 10 weeks later

These return times are horrendous and (I promise) these are massive talents of the top level of soccer. You'd think they would have better treatment.  (Looks like they need to expand podiatry in the UK.)

I'll leave you with one more soccer injury.  David Beckham, well known to even us, recently ruptured his achilles which dashed his hopes of playing in one more World Cup for England.  To add insult to injury, his wife Posh Spice (aka Victoria Beckham) went to a premiere without him.  She explained to the media, he's at home hobbling around and helping the kids with their maths homework.  Poor little buggers; they won't learn much.

Dennis Claire, PGY2, armchair footballer
ST Vincent Hospital
Worcester Massachusetts

PS--one more great sports/podiatry article to read.  This one is about Dr. Saxena's repair of the world record holder in the women's marathon's bunion surgery.  Entertaining to read from our perspective.

Re: The Foot Injuries of Professional Athletes

I remember when I was at OCPM when the Cleveland Cavaliers drafted a very promising, 7'3", 260 pound big center from Lithuania, also known as "Z", Zydrounas Ilgauskas.  Z fractured his navicular in 1996, his rookie season, missed the 1996-1997 season on injured reserve for his fractured left navicular bone. 

In 2000, Z removed himself from a game in Miami, and was diagnosed with a right foot navicular fracture.  He missed most of the next two seasons rehabilitating the foot.

His FIRST productive season came in 2002-2003, when he averaged 17.2 points, 7.8 rebounds and 1.8 blocks per game.  He was named to the Eastern All-Star Team. 

He has never truly played a full season in his NBA career.

Just goes to show you that size doesn't always matter.  At 7'3", its amazing that it was only his navicular that he fractured. In February 2010, Boston forward Paul Pierce fractured his left foot in the middle of a game:


Currently, the most prominent big man to get hit by the injury bug is 7'6" Houston center, Yao Ming.  Yao stress fractured his navicular bone as well.   He would miss the rest of the postseason after suffering a stress fracture of the tarsal navicular bone in his left foot for the second straight year.  There are talks the he might never play again.  Keep in mind, he anchored his country's men's team in the 2008 Beijing Olympics.

It was the fourth consecutive season in which Yao was severely hampered by a bone injury in his lower extremities.Paging through the NBA’s history book, there are a number of prominent big men who had trouble shaking the injury bug in their lower extremities. Bill Walton might be the most famous, having played in just 44 percent of his teams’ regular-season games during a 13-year career. Players such as Sam Bowie, Rik Smits and Greg Oden have had similar problems.
 

Walton and Ilgauskas might have the most in common with Yao; they, too, have dealt with the uncommon fracture of the tarsal navicular bone.

So why the navicular?  Most likely, most basketball big men are pes planovalgus foot type, and the navicular probably takes 1-1/2 to 2 times the body weight during professional sports compared to regular people.  The lack of mechanical advantage of the posterior tibialis against the foot stresses the navicular tuberosity.

anyone else with a thought?

Eric 

Re: The Foot Injuries of Professional Athletes

Thank you for your vantage point on Knocks in soccer athletes.  My son is an avid fan.  My father was a professional player in Europe and my grandfather was a coach for the Maccabi team. As an "American Boy", I would only watch baseball, football, basketball and hockey.  At my sons urging, I have eliminated baseball and replaced it with  soccer.  The Europeans have kept this secret way too long.  There seems to be a disproportionate amount of metatarsal injuries.  Does this happen as a result of another player landing on their foot with a cleat? 

Re: The Foot Injuries of Professional Athletes

I would love to see the x rays on Ilgauskas because what is commonly reported as a navicular stress fracture is really a displacement of os tibiali externum or accessory navicular.   In essence, we are really talking about a rupture of the cartilaginous attachment to the true navicular.  I wonder if that's whats plaguing these boys. 

If you take any person with a minor foot flaw, make him seven feet tall and 300+ pounds, and it becomes a real problem. 

Re: The Foot Injuries of Professional Athletes

Wow, that's fantastic that you have so much family history at the professsional level. Does your son want to play professionally as well?  It is an exciting game to follow, I don't understand why more of us here don't enjoy it.
I'd say many metatarsal injuries are a result of feet being stepped on at speed and during tackles.  I'm sure the flimsy football boots don't help.
Lisfranc injuries seem to be happening more in soccer as well as american football.  This was a good article I read a few years ago on the topic.  It also points to shoegear with poor midfoot stability as one of the possible reasons.


Am J Sports Med.
2002 Nov-Dec;30(6):871-8.

Classification, investigation, and management of midfoot sprains: Lisfranc injuries in the athlete.

Re: The Foot Injuries of Professional Athletes

Derek Jeter is my favorite player, but the Yankees are not my favorite baseball team.  Please notice I did not limit Jeter only as my favorite baseball player.  He is my favorite of any professional PLAYER of any sport.  To my untrained eye he was always maximum alert and had ultra  game intelligence. His talent+ hustle make him the best Yankee player ever!  His xrays of injury and repair would be priceless for teaching podiatrists and orthopedists in medical schools.  Why?  Because of the emotional appeal and human memory!!   We could make him famous!!       Dwight L. Bates, DPM